Vascular Surgery

Vascular surgery is the diagnosis, management, and treatment of conditions of the vascular system including arteries, veins, and lymphatic vessels.

Vascular diseases are increasingly common and can be serious. They can damage blood vessels and raise the risk of complications such as strokes and heart attacks.

Vascular surgeons perform diagnostic tests, give lifestyle advice, and provide medication. They carry out a range of minimally invasive endovascular and open surgical procedures.

Vascular surgery is performed to restore blood and lymph flow to organs in your body. It: 

• repairs damaged blood vessels caused by vascular disease by unblocking, reconstructing, and bypassing arteries and veins.
• lowers complication risks of these diseases and helps prevent strokes, amputations, and sudden death.
• increases mobility, relieves pain, and improves patients’ quality of life.
• creates access to blood vessels for medical therapies such as dialysis.

Vascular surgeons are experts in diseases of the arteries, veins, and lymphatic vessels. You might be referred to a vascular surgeon if you are at high risk or you have symptoms of a vascular disease.

Risk factors for vascular diseases vary depending on the specific disease. More common risk factors include:

• Ageing 
• Having a condition that can affect your heart and blood vessels, such as diabetes or high cholesterol
• A family history of vascular or heart diseases
• Physical inactivity
• Obesity
• Smoking

The symptoms for each disease are different. They can include:

• Arm or leg aches or cramps
• Bulging vein clusters underneath the skin’s surface
• Unusually cold limbs 
• Pale, bluish or brown skin
• Swelling in the affected area
• A weak or numb limb that is difficult to use
• Slow-healing wounds.

At your initial consultation, a vascular surgeon will discuss your symptoms and your and your family’s medical history. They will perform a physical examination which may include checking your pulse and blood pressure. Blood or imaging tests may be requested to help them diagnose your problem. 

Vascular disease diagnostic tests include:

• Blood test - checks cholesterol levels if atherosclerosis (narrowed arteries) is suspected.
• Angiography - uses X-ray imaging and a special dye to evaluate blood flow through the arteries.
• Ultrasound – uses sound waves to assess blood flow through arteries.
• CT scan – uses cross-sectional X-ray images of the body, including the aorta to check for and evaluate Abdominal Aortic Aneurysm (AAA).
• MRI - uses magnetic fields and radio waves to create detailed images of blood vessels.

Vascular surgeons treat many types of vascular disease. The more common ones include:

• Carotid Artery Disease (CAD) - also called carotid artery stenosis. Plaque builds up (atherosclerosis) inside your carotid arteries that carry blood to your brain and head. Narrowing can cause a stroke.
• Abdominal Aortic Aneurysm (AAA) - an enlargement or “bulge” develops in a weakened abdominal area of your main artery (aortic). It can lead to rupture and death.
• Peripheral Arterial Disease (PAD) – also called peripheral vascular disease. A common circulatory problem where blood vessels outside the heart and brain become narrowed and reduce blood flow, usually to your legs and sometimes your arms. It can lead to leg amputation.
• Varicose Veins – veins become swollen and enlarged, usually on your legs and feet. They can be painful and look unsightly.

Vascular surgeons may recommend non-surgical treatments. These can include lifestyle modifications such as stopping smoking, losing weight, and taking regular exercise.

Medications may also be offered to manage and treat vascular conditions. Examples include dialysis for patients whose kidneys don’t function, thrombolysis to break up dangerous blood clots and manage deep vein thrombosis (DVT), and micro-sclerotherapy to treat thread veins. Massage and compression bandaging may be used for lymphatic diseases.

The main vascular surgery procedures include:

•                     Carotid Artery Disease (CAD) Surgery – opens narrowed carotid arteries that are restricting blood supply. Treatment improves blood flow to your brain and reduces the risk of a stroke. It can include:

o   Carotid endarterectomy - removes plaque from carotid arteries.

o   Carotid angioplasty and stenting - opens up arteries using balloons and stents.

•                     Abdominal Aortic Aneurysm (AAA) Repair – reduces the risk of an aneurysm bursting in your main artery. It can be performed by:

o   AAA open surgery - removes the damaged part of your aorta (the aneurysm) and replaces it with a fabric tube graft via a large incision.

o   Endovascular aneurysm repair (EVAR) - places a stent graft at the aneurysm via small incisions. EVAR is less invasive and recovery is faster.

•                     Thoracic Aortic Aneurysm (TAA) Repair– similar to AAA repair but for thoracic aortic aneurysms. A TAA is higher up the aorta in your chest.

o   TAA open surgery – replaces the weakened portion of your aorta with a fabric graft tube via a large incision.

o   Thoracic endovascular aortic repair (TEVAR) – uses minimally invasive surgery to place a stent graft at the aneurysm.

•                     Thrombectomy / Embolectomy – removes a blood clot or foreign body from a blood vessel. This prevents the vessel from being obstructed or blocked and restores blood flow to body parts.

•                     Peripheral Artery Disease (PAD) Surgery - restores blood flow through the arteries in your legs, called revascularisation. The two main types of PAD treatment are:

o   PAD angioplasty and stenting - inflates a tiny balloon inside your artery to open up a blocked or narrowed section and restore blood flow.

o   PAD artery bypass grafts - uses a healthy blood vessel or artificial material to bypass the blockage in your artery.

•                     Varicose Vein Surgery – treats problematic or unsightly varicose veins that are not resolving by conservative methods, such as compression stockings. Varicose vein surgery includes:

o   laser or radiofrequency ablation - uses a heat source to close your vein

o   sclerotherapy - injects a medicine to shrink your vein.

The most common vascular surgery treats arteries that are blocked by atherosclerosis (plaque). This is either carotid or peripheral artery surgery.

Endovascular aneurysm repair and thrombectomy are also frequently performed.

The costs of vascular surgery depend on your vascular disease, the best course of treatment for it, and your Ramsay hospital of choice.

After a vascular surgeon consultation, you receive a formal quote that is valid for 60 days and includes unlimited aftercare.

We have several finance options if you are paying for your surgery yourself. These include:

• Interest-free finance – monthly instalments with no deposit and 0% interest.
• All-inclusive Total Care - a one-off payment for all the treatment you need at a pre-agreed price.
• Pay as you go – if your treatment costs are difficult to assess or you want to pay for your treatment costs as and when they arise.

Vascular surgery is covered by most medical insurance policies unless it is varicose vein treatment for cosmetic reasons. We advise you to obtain written confirmation from your insurance company before having vascular surgery.

Recovery after vascular surgery depends on your condition and surgery.

Minimally invasive endovascular surgery has a much quicker recovery than open vascular surgery.

Varicose vein procedures are often performed on an outpatient basis so you can go home a few hours after surgery.

Angioplasty and stenting are often day case surgeries which means you go home the same day.

Open abdominal aortic aneurysm repair surgery is a major operation. Most patients recover in intensive care and have a five to ten day stay in the hospital. Full recovery may take two or three months.

Patients are invited for a follow-up appointment to check their recovery and to offer lifestyle advice and support.

At Ramsay Health Care, we offer a wide range of vascular services to diagnose, manage, and treat vascular disorders.

We are proud to work in partnership with leading vascular surgeons who have specialised experience in all aspects of vascular and lymph conditions. Taking a holistic approach to their patients and paying careful attention to co-morbidities, they provide the best care and treatment.

Vascular surgeons at Ramsay work as part of a multidisciplinary team to deliver multi-professional care. They work closely with specialists in vascular medicine, heart conditions (cardiovascular medicine), nervous system conditions (neurology), physical medicine and rehabilitation, and imaging (radiology).

These expert vascular surgeons carry out balloon angioplasty and complex stenting procedures, blood clot removal, and bypass surgery. They treat vascular conditions including peripheral artery disease, aortic aneurysm disease, carotid artery disease, and varicose veins.

At your local Ramsay hospital, the latest vascular and endovascular surgical techniques are performed in state-of-the-art facilities with excellent outcomes and rapid recovery.